Transient ischemic attacks: a single institutional experience
Abstract
Abstract Background: Transient ischemic attack (TIA) is a neurological emergency. About 15-30% of strokes are preceded by TIAs. We aimed to evaluate the risk factors developing TIAs, assess all patients with diffusion weighted MRIs, and to initiate early treatment to prevent completed strokes. Method: This cross-sectional observational study was conducted from December 1, 2018, to October 31, 2019. Eighty patients, who developed TIAs and who had attended the Rizgary Teaching Hospitals emergency department and its neurology outpatients clinic at Erbil, Iraq, were enrolled consecutively. All patients underwent thorough medical and neurological examinations, the ABCD2 score was calculated in all patients, and an extensive battery of investigations, including an emergency brain CT scan and MRI with diffusion-weighted images (DWI) were done. After securing the diagnosis of TIA, all patients were treated with antiplatelets or anticoagulants in addition to other medications, as needed. Results: The mean age of patients was 56.63 (SD of 11.6 years). The most common risk factor was hypertension (53.7%) followed by diabetes and smoking. The commonest presentation was acute hemiparesis followed by hemianesthesia. DWI sequences demonstrated acute ischemic infarctions in 15 (18.7%) patients. Conclusion: TIAs targeted people younger than expected by other international studies. DWI of the brain is more sensitive than conventional brain MRI sequences in detecting the acute ischemic changes in patients with TIAs. Keywords: TIA, stroke, ischemia, MRI, DWI
References
- Anaesthesia department, Medical Technical Institute, Erbil Polytechnic University.
- Ashti Mohammad Amin Said
- Assistant Professor of Community Medicine, Shekhan Technical College of Health, Duhok olytechnic University. Corresponding author: [emailprotected]
- DOI:10.33899/mjn.2020.167520
- had found that 5% of TIA is due to AF. In this study we found that 6.25% TIA due to carotid stenosis.
- he found that the risk of recurrent TIA within one year is about 12%, in our patients the rate is more than that which could be due to ignorance of the treatments, lack of exercise or unhealthy dietary program. In this study the frequency of patients with AF was 3.75%, in a previous publication by Lavallee et al 2007
- hyperlipidemia was found in 14 (17.5%) patients, this is near to 19.2% by Kimura et al 2004 and Cucchiara et al 2006.[15,16]
- There was previous TIA in 16.25% patients, in a study by Hankey 2003
- Medical Research Center, Hawler Medical University, Kurdistan Region, Iraq Verified email
- Shewaaz Shamsaulddin Taha
- The incidence of TIA, for example, in the United States, has been estimated to be about 200 000-500 000 per year, with a population prevalence of 2.3% that translates into 5 million individuals.[2,3]Thus, the actual prevalence of this condition may be considerably larger.
- the mean duration of symptoms was 42.66 minutes, in 66 patients the duration of symptoms was less than one hour this is consistent with previously published study by Calvet et al 2007.
- The most common risk factor was hypertension, this agrees with other studies by Inoue et al 2004, Sheehan et al 2010, Hill et al 2004 and Lisabeth et al 2004,[8,10-12] other risk factors like smoking (28.8%), IHD (15%), were near to the results of previously published studies by Inoue et al 2004 and Tsivgoulis et al 2006.[8,13] Twenty four (30%) patients were diabetic, which is similar to that of Purroy et al 2007,
- There are an estimated 800,000 acute completed ischemic strokes per year in the United States, and it is estimated that 15-30% are preceded by a transient ischemic attack.[5,6] The Cardiovascular Health Study estimated a prevalence of TIA in men of 2.7% for 65-69 years of age and 3.6% for 75-79 years of age, while for women, TIA prevalence was 1.6% for 65-69 years of age and 4.1% for 75-79 years of age. In the younger Atherosclerosis Risk in Communities cohort study, the overall prevalence of TIAs was found to be 0.4% among adults 45-64 years of age.
- TIA reduces survival by 4% in the first year and by 20% within 9 years.
- Transient ischemic attacks: a single institutional experience
- DOI:10.33899/mjn.2020.1675202020, College of Nursing, University of Mosul.
- Creative Commons Attribution 4.0 International Licensehttps://mjn.mosuljournals.com/article_167520.html
- Aso Sabir Skeikh bezeni
- Yasin Kareem Amin